I posited, and have buttressed, “triage theory” (1,2): metabolism responds to
moderate deficiency of an essential vitamin or mineral (V/M) so that the scarce
V/M is preferentially retained by V/M-dependent proteins necessary for
short-term survival and reproduction. In contrast, proteins needed for long
term health, which I term “longevity proteins” because they defend against the
diseases associated with aging, lose the V/M and are disabled. Most of the
world’s population, including that of the U.S., are moderately deficient in one
or more of the ~30 essential V/Ms. Moreover, since the damage from moderate
deficiency is insidious, its importance for long-term health is not being
appreciated. Strong support for triage theory comes from Joyce McCann’s analyses
of the literature on proteins dependent on vitamin K (3) and on selenium (4).
Both have built into metabolism this trade-off between short-term survival and
long-term health and each uses a different mechanism to accomplish this end.
Theory and evidence suggest that this metabolic trade-off accelerates
aging-associated diseases, such as cancer, cognitive decline, and cardiovascular
disease. Importantly, by the official U.S. Institute of Medicine measure of
inadequacy, the EAR (Estimated Average Requirement; the RDA is set at 2 SD above
the EAR), most of the U.S. population is below the EAR for one or more V/M.
Taking these long-term triage effects into account in setting EARs could lead to
numerous changes. We have calculated from the NHANES database that the
percentages of the U.S. population that are below the EAR are: magnesium 56%;
zinc 12%; iron 16% of menstruating women; vitamin B6 49% of elderly women;
folate 16% of adult women. The U.S. population also has very low intake of
vitamin D, calcium, potassium, omega-3 fatty acids, vitamin K, and probably
others, and this is especially true for children, adolescents, elders, and the
obese. Longevity proteins, about half of those studied, indicate a mechanism
that could be used for prevention by monitoring for insidious damage and suggest
the existence of an undiscovered class of longevity V/Ms, which we are
discovering. Our Choribar (V/M-dense, low-calorie, high-fiber, fruit-based)
markedly improves metabolism in many human trials.